Psychiatrists are frequenlly challenged to differentiate primary psychiatric symptoms from those that arise secondary to medical illness. Errors in clinical assessment can lead to significant morbidity and even mortality. Wernicke's encephalopathy is a medical condition that presents, in part, as psychiatric symptomatology. Despite an estimated incidence of 2%, 80% of the cases are undiagnosed. Of its classic triad, ophthalmoplegia and ataxia call be quite subtle, or even absent, whereas mental status changes are present in all but 10% of cases. This disorder, although widely recognized as a complication of alcoholism, has many less frequently considered etiologies, including iatrogenic causes, which may constitute a large fraction of the unrecognized cases. The author looks at a case of Wemicke's encephalopathy that was iatrogenically induced and presented aspsychiatric symptomatology.
Geenans, D.O., Douglas
"A Psychiatric Presentation of Wernicke's Encephalopathy Following Intravenous Fluid Administration,"
Jefferson Journal of Psychiatry:
2, Article 5.
Available at: http://jdc.jefferson.edu/jeffjpsychiatry/vol10/iss2/5